Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan;
Anticancer Res. 2023 Sep;43(9):4213-4219. doi: 10.21873/anticanres.16613.
BACKGROUND/AIM: In colorectal cancer cases, treatment strategies differ between those with regional and extra-regional lymph node metastases. The inferior mesenteric lymph nodes are categorized as regional lymph nodes, while the para-aortic lymph nodes are classified as extra-regional lymph nodes. Although inferior mesenteric and para-aortic lymph node metastases are both associated with a dismal prognosis, few prognostic comparisons have been conducted. The present study aimed to clarify the prognosis of inferior mesenteric and para-aortic lymph node metastases in rectal cancer.
We retrospectively evaluated 71 patients with pathologically diagnosed rectosigmoid or rectal cancer with inferior mesenteric lymph node metastasis and 27 with pathologically diagnosed rectosigmoid or rectal cancer with para-aortic lymph node metastasis who underwent curative surgery. They were identified from the Japanese Study Group for Postoperative Follow-Up of Colorectal Cancer database. Overall survival, recurrence-free survival, and recurrence patterns were compared between the two groups.
The five-year recurrence-free survival rates of patients with inferior mesenteric and para-aortic lymph node metastases were 31.2 and 28.1%, respectively (p=0.37), and the five-year overall survival rates were 43.1 and 39.6%, respectively (p=0.60). Furthermore, the survival curves of the two groups almost overlapped for both recurrence-free survival and overall survival rates. Recurrence patterns did not significantly differ between the two groups.
In rectal cancer, the prognosis of inferior mesenteric lymph node metastasis is similar to that of para-aortic lymph node metastasis. Inferior mesenteric lymph node metastasis has a poor prognostic impact on rectal cancer.
背景/目的：在结直肠癌病例中，区域性和区域性以外淋巴结转移的治疗策略有所不同。肠系膜下淋巴结为区域性淋巴结，而腹主动脉旁淋巴结为区域性以外淋巴结。虽然肠系膜下和腹主动脉旁淋巴结转移均与预后不良相关，但很少有预后比较。本研究旨在阐明直肠癌肠系膜下和腹主动脉旁淋巴结转移的预后。
我们回顾性评估了 71 例经病理诊断为直肠乙状结肠或直肠癌伴肠系膜下淋巴结转移和 27 例经病理诊断为直肠乙状结肠或直肠癌伴腹主动脉旁淋巴结转移的患者，这些患者均接受了根治性手术。这些患者来自日本结直肠癌术后随访研究组数据库。比较两组患者的总生存、无复发生存和复发模式。
肠系膜下和腹主动脉旁淋巴结转移患者的五年无复发生存率分别为 31.2%和 28.1%（p=0.37），五年总生存率分别为 43.1%和 39.6%（p=0.60）。此外，两组患者的无复发生存率和总生存率的生存曲线几乎重叠。两组患者的复发模式无显著差异。
在直肠癌中，肠系膜下淋巴结转移的预后与腹主动脉旁淋巴结转移相似。肠系膜下淋巴结转移对直肠癌预后有不良影响。
